Repair of atrial septal defect through a minimal right vertical infra-axillary thoracotomy in a beating heart

Yang, Xiubin; Wang, Dongjin; Wu, Qingyu

doi:10.1016/s0003-4975(01)02470-5

Cited by 32 publications

(29 citation statements)

References 4 publications

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“…The surgical technique for RVIAT has been previously described 7–9 . In brief, the patient was positioned with the right side elevated about 60∼90°.…”

Section: Methodsmentioning

confidence: 99%

“…Previously in our department, right vertical infraaxillary thoracotomy (RVIAT) has been used for open heart procedures such as atrial septal defects (ASDs), 7 ventricular septal defects, 8 and mitral valve replacement, 9 with good clinical and cosmetic results. On the basis of past experience, this technique was also used for mitral valve repair in patients with MR due to leaflet prolapse.…”

mentioning

confidence: 99%

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Surgical Repair of Mitral Valve Prolapse Through a Minimal Right Vertical Infraaxillary Thoracotomy

Pan

Wang

et al. 2012

Journal of Cardiac Surgery

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“…The surgical technique for RVIAT has been previously described 7–9 . In brief, the patient was positioned with the right side elevated about 60∼90°.…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Surgical Repair of Mitral Valve Prolapse Through a Minimal Right Vertical Infraaxillary Thoracotomy

Pan

Wang

et al. 2012

Journal of Cardiac Surgery

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“…Right thoracotomy has been reported as a safe method, with minimal complications for cardiac operations [4,5] and most recently right mini-thoracotomy has achieved better results in terms of perioperative complications, hospital stay and need of pain control [2]. Furthermore, in selected patients, robotic cardiac surgery with right chest ports has been proven safe and effective in cardiac surgery [6].…”

Section: Discussionmentioning

confidence: 99%

Management of a Heart Myxoma Through a Right Thoracotomy in a Patient With a Previous Sternotomy

et al. 2016

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Myxoma is the most common benign cardiac tumor, presenting most frequently in the left atrium. Median sternotomy has been traditionally used to provide access to the heart and the mediastinal structures in cardiac operations. Recently, right thoracotomy and minithoracotomy have been used as an alternative. We present a case of a patient with left atrial myxoma, who had been subjected to coronary artery bypass graft 2 years ago. The previous full median sternotomy urged the need for another approach. A right lateral thoracotomy with one lung ventilation was chosen, offering excellent access to the heart and mediastinum. The patient was set under cardiopulmonary bypass and cardioplegia and the mass was excised through a left atrial incision. The perioperative course was free of complications. We suggest that right thoracotomy is a safe and efficient way of treating cardiac tumors in selected patients, when median sternotomy is considered complicated, not possible or contraindicated.

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“…In terms of cosmetic results, RVAM is superior to median sternotomy and right posterolateral thoracotomy [9]. In the repair of small cardiac congenital defects like ASD, drawbacks of median sternotomy is include the length of the incision in the median sternotomy, postoperative pain, non-ideal cosmetic results, and possible complications of the sternotomy (mediastinitis, osteomyelitis, etc.)…”

Section: Discussionmentioning

confidence: 99%

Atrial Septal Defect Closure: Comparison of Vertical Axillary Minithoracotomy and Median Sternotomy

Poyrazoglu

Avsar

Demir

et al. 2013

Korean J Thorac Cardiovasc Surg

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BackgroundThis study aims to evaluate whether or not the method of right vertical axillary minithoracotomy (RVAM) is preferable to and as reliable as conventional sternotomy surgery, and also assesses its cosmetic results.MethodsThirty-three patients (7 males, 26 females) with atrial septal defect were admitted to the Cardiovascular Surgery Clinic of Cukurova University from December 2005 until January 2010. The patients' ages ranged from 3 to 22. Patients who underwent vertical axillary minithracotomy were assigned to group I, and those undergoing conventional sternotomy, to group II. Group I and group II were compared with regard to the preoperative, perioperative and postoperative variables. Group I included 12 females and 4 males with an average age of 16.5±9.7. Group II comprised 14 female and 3 male patients with an average age of 18.5±9.8 showing similar features and pathologies. The cases were in Class I-II according to the New York Heart Association (NYHA) Classification, and patients with other cardiac and systemic problems were not included in the study. The ratio of the systemic blood flow to the pulmonary blood flow (Qp/Qs) was 1.8±0.2. The average pulmonary artery pressure was 35±10 mmHg. Following the diagnosis, performing elective surgery was planned.ResultsNo significant difference was detected in the average time of the patients' extraportal circulation, cross-clamp and surgery (p>0.05). In the early postoperative period of the cases, the duration of mechanical ventilator support, the drainage volume in the first 24 hours, and the hospitalization time in the intensive care unit were similar (p>0.05). Postoperative pains were evaluated together with narcotic analgesics taken intravenously or orally. While 7 cases (43.7%) in group I needed postoperative analgesics, 12 cases (70.6%) in group II needed them. No mortality or major morbidity has occurred in the patients. The incision style and sizes in all of the patients undergoing RVAM were preserved as they were at the beginning. Furthermore, the patients of group I were mobilized more quickly than the patients of group II. The patients of group I were quite pleased with the psychological and cosmetic results. No residual defects have been found in the early postoperative period and after the end of the follow-up periods. All of the patients achieved functional capacity per NYHA. No deformation of breast growth has been detected during 18 months of follow-up for the group I patients, who underwent RVAM.ConclusionTo conclude, the repair of atrial septal defect by RVAM, apart from the limited working zone for the surgeon in these pathologies as compared to sternotomymay be considered in terms of the outcomes, and early and late complications. And this has accounted for less need of analgesics and better cosmetic results in recent years.

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Repair of atrial septal defect through a minimal right vertical infra-axillary thoracotomy in a beating heart

Cited by 32 publications

References 4 publications

Surgical Repair of Mitral Valve Prolapse Through a Minimal Right Vertical Infraaxillary Thoracotomy

Surgical Repair of Mitral Valve Prolapse Through a Minimal Right Vertical Infraaxillary Thoracotomy

Management of a Heart Myxoma Through a Right Thoracotomy in a Patient With a Previous Sternotomy

Atrial Septal Defect Closure: Comparison of Vertical Axillary Minithoracotomy and Median Sternotomy

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